?Surgery can slow Parkinson?s progression?

A PERSON suffering from Parkinson?s disease (PD) cannot perform simple actions such as lifting one?s hand or moving his legs, which an average person can do without any effort. PD is a degenerative, neurological disorder of the central nervous system that affects the patients motor skills, but a surgery, though costly, can be an answer to manage the ailment afflicting about 5,00,000 persons in India.

A PERSON suffering from Parkinson’s disease (PD) cannot perform simple actions such as lifting one’s hand or moving his legs, which an average person can do without any effort. PD is a degenerative, neurological disorder of the central nervous system that affects the patients motor skills, but a surgery, though costly, can be an answer to manage the ailment afflicting about 5,00,000 persons in India.

“Unlike Alzheimer’s disease, Parkinson’s disease can be managed,” says noted neurosurgeon from Mumbai’s Jaslok Hospital Dr Paresh Doshi. In PD, brain cells, which produce dopamine, a chemical that transmits brain’s message to nerves and muscles, are destroyed gradually. The common symptoms include rigidity in movement of hands or legs, tremors and shuffles and a mask-like face (a face without any emotions).

Till the mid-90s, patients in India depended on Levodopa, though it has side effects. Surgical procedures now available since 1996 give considerable relief to patients. In the first kind of surgery a lesion, a small area in the brain is destroyed while in the second type of operation called the deep brain stimulation, an electrode is passed in the brain with wires connecting it to a device inserted near the collarbone under the skin.

An IPG (implantable pulse generator) device—a pacemaker for brain—is surgically implanted to deliver carefully controlled electrical stimulation to precisely targeted areas within the brain. “The operation to implant the device, called deep brain stimulation, is not a cure for PD but after this, the progress of the disease is slower,” Dr Doshi, who was the first doctor to perform deep brain stimulation in 1998 at Mumbai, said.

Two doctors from abroad performed this surgery in India in 1996 for the first time. Since 1998, Dr Doshi has till date performed 160 similar procedures—including both lesion and deep brain stimulation (102 cases) at Jaslok Hospital. “The surgeries have been able to reduce drug dependence in many patients and in a few cases, medicines
have been stopped completely.

The patient returns to his normal life and activities,” the neurologists, who is the only Asian in the International Task Force for Movement Disorder Surgery, said this during a select media briefing here on Wednesday.

However, relatively higher cost can prove a deterrent for the common man. “The device itself costs Rs 3.7 lakh. Add to it the cost of the surgery, which can be Rs 1.5 lakh to Rs 2 lakh. “But now more and more people are willing to
undergo this surgery as the quality of life changes several times after this,” Dr Doshi added.

The two surgeries—involving the lesion and also the deep brain stimulation—however are currently available at Mumbai only as there is a dearth of neurosurgeons trained in this sophisticated kind of procedure.